Forms

If the patient is an adult, go to the “All Adults” section and complete the listed forms, or if the patient is a child or adolescent, complete the forms under “All Children/Adolescents.” Other forms may or may not be applicable; we can discuss that at the first session. If you do not yet have Adobe Acrobat Reader DC installed on your computer to open PDFs, you can download it for free from Adobe here.

Some of these forms are "fillable" PDFs that can be completed on your computer. Depending on your browser and email, you may be able to send in the filled-out forms by clicking the “Submit Form” button at the end of each form. Follow the steps provided to open your email and find the new message in your Drafts folder (with the completed form attached) addressed to doc4add@mindspring.com.
Or, completed forms can be uploaded from your computer to our Contact page or attached to an email sent to Dr. Buchanan at doc4add@mindspring.com. Forms can also be printed and faxed to (678) 624-0258. If you plan to bring completed forms with you to the first session, PLEASE PRINT TWO-SIDED if possible.

All Adults:

Adult Intake Form

npp_adult_intake_form_07232022a.pdf
File Size:	306 kb
File Type:	pdf

Download File

Psychological Services Contract

npp_psychological_services_contract_07252022a.pdf
File Size:	314 kb
File Type:	pdf

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HIPAA

npp_hipaa_07252022a.pdf
File Size:	283 kb
File Type:	pdf

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All Children/Adolescents:

Child/Adolescent Intake Form

npp_child_adolescent_intake_form_07272022a.pdf
File Size:	254 kb
File Type:	pdf

Download File

Psychological Services Contract

npp_psychological_services_contract_07272022a.pdf
File Size:	318 kb
File Type:	pdf

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HIPAA

npp_hipaa_07252022a.pdf
File Size:	283 kb
File Type:	pdf

Download File

If the child or adolescent is here for testing, also complete the following:

Developmental and Medical History

npp_developmental_and_medical_history_07272022a.pdf
File Size:	1098 kb
File Type:	pdf

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Authorization of Release of Information Forms:
A separate Release Form is required for each person or facility sending/receiving information to/from us.
Please be sure to sign each Release Form in two places.

Adult Release Form

npp_adult_release_form_07272022a.pdf
File Size:	661 kb
File Type:	pdf

Download File

Child/Adolescent Release Form

npp_child_adolescent_release_form_07272022a.pdf
File Size:	288 kb
File Type:	pdf

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Informed Consent for Forensic Services:

Custody Evaluation

npp_informed_consent_for_psychological_custody_evaluation_07272022a.pdf
File Size:	281 kb
File Type:	pdf

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Psychological Evaluation During a Legal Dispute

npp_informed_consent_for_psychological_evaluation_during_a_legal_dispute_07272022.pdf
File Size:	507 kb
File Type:	pdf

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Forensic Psychological Evaluation

npp_informed_consent_for_forensic_psychological_evaluation_078272022a.pdf
File Size:	272 kb
File Type:	pdf

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Collateral Agreement

npp_collateral_agreement_07272022a.pdf
File Size:	204 kb
File Type:	pdf

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MFT Supervision:

Supervision Contract

npp.aamft.supervision.contract_10022022a.pdf
File Size:	255 kb
File Type:	pdf

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